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Managing Bone Marrow Suppression in Children

Managing Bone Marrow Suppression in Children

What is bone marrow suppression?

Nearly all chemotherapy agents cause a drop in blood cell counts. This is because the chemotherapy makes it harder for the bone marrow to make blood cells the way it normally does. This is called bone marrow suppression. The drop in blood cell counts varies according to which agents are used for your child's treatment. Red blood cells that carry oxygen, white blood cells that fight infection, and platelets that control bleeding are usually lowered with chemotherapy use. Risk for anemia, fatigue, infection, and bleeding are increased with bone marrow suppression. Common terms that you may hear that refer to blood cell reduction include the following:

Anemia. This is a decrease in red blood cells.

Neutropenia. This is a decrease in neutrophils (a specific type of white blood cell; a main defense from bacteria).

Thrombocytopenia. This is a decrease in platelet counts.

Pancytopenia. This is a decrease in all types of blood cells--red blood cells, white blood cells, and platelets.

While your child is undergoing chemotherapy treatment, these blood cell levels will be monitored frequently. Many parents like to keep track of their child's blood counts to record their progress. Ask your child's doctor what levels are acceptable for your child.

What are symptoms of bone marrow suppression?

The following are the most common symptoms of bone marrow suppression. However, each child may experience symptoms differently. Symptoms may include:

Low platelets:

Easy bruising

Bleeding: nose bleeds, gums, or mouth

Tiny red spots on the skin (petechiae)

Blood in the urine

Dark or black bowel movements

Low white blood cells:

Fever and chills

Rash

Diarrhea

Sore throat

Pain or burning when passing urine

Cough or shortness of breath

Signs of infection (anywhere in the body):

Swelling

Pus or drainage

Redness

An area that is warm to touch

Low red blood cells:

Fatigue (extreme tiredness that doesn't get better with rest)

Paleness of skin, lips, and nail beds

Increased heart rate

Tires easily with exertion

Dizziness

Weakness

Shortness of breath

Treatment and prevention of complications of bone marrow suppression

There are several things you can do for your child to prevent complications of bone marrow suppression. Your child may be given specific medications to help stimulate the production of cells in the bone marrow. While you are waiting for your child's blood counts to return to a healthy range, consider the following: